WASHINGTON – President Barack Obama struck a blow for same-sex couples without picking a drawn-out fight with conservatives this week when he ordered hospitals around the country to honor patients’ wishes about who may visit their sickbeds or risk losing Medicaid and Medicare money.
By using federal spending power to make sure hospitals respect all legally valid advance directives, Obama handed gay rights advocates a clear victory.
But the president’s directive creates no new rights or benefits and does not apply only to gay couples. So in issuing it, Obama sidestepped the more controversial question of whether same-sex couples are entitled to broader legal recognition of their partnerships.
While some conservative groups expressed skepticism about the president’s broader goals, they largely endorsed the memo’s effect. The response was considerably more muted than the reaction to other gestures the president could have made to this critical part of his Democratic base of support.
More than a year after Obama was inaugurated, many of those supporters are agitated over his reluctance to press Congress to pass an employment nondiscrimination act. Frustrating for others is his slow march toward repeal of the “don’t ask, don’t tell” policy banning gays from serving openly in the military, a step that will be under study by the military at least through the rest of this year.
In that context, the hospital visitation measure represented a bow to pragmatism and, some advocates feared, a tacit recognition that other priorities for the gay community may be stalled this year.
“They’ve been getting a lot of pressure from the gay community,” said Jimmy LaSalvia, executive director of GOProud, a group of gay conservatives. “They’re either unwilling or unable to deliver on their promises and they had to come up with something.”
At the same time, LaSalvia said, conservatives are likely to stand aside for the memo.
“Hospital visitation is not a lightning rod,” he said. “I think the folks reacting harshly to this decision are on the fringe of the fringe.”
The Catholic Health Association, which represents 1,200 systems and facilities across the nation, applauded the move, saying that it emphasizes the importance of letting patients decide who comes to their bedside.
“We have long championed the rights of all patients to designate who they want to speak for them in health care decisions when they are not able to speak for themselves,” said Carol Keehan, president and chief executive officer of the association. “All persons of goodwill can understand and agree that when a person is sick, they deserve to decide who they want to visit them.”
Groups opposed to expanding legal rights for same-sex couples offered careful criticism.
“We would agree with the spirit of it,” said Carrie Gordon Earll, the senior director of public policy for the conservative advocacy group Focus on the Family.
For more than a year, gay right advocates have complained that Obama has not moved far enough.
On perhaps the most high-profile issue – repealing the “don’t ask, don’t tell” law – advocates hope the administration would include the repeal in a defense authorization bill set to come before the Senate next month.
“I’ll reserve judgment for May,” said Alex Nicholson, the executive director of Servicemembers United, a group pushing for repeal of the law. “I would say that if we see one or two more of these coming out then my ears will perk up.”